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Friday, March 20, 2009

Forecast: Increasing Wait Times, Frequent Boys

In August 2008, in the midst of the Beijing Olympic Games, I collected data from the six largest adopting Provinces in China to look at the near-term prospects for a referral speed-up. At that time, faced with ever declining submission rates, I predicted that referrals would continue to decrease, and wait times increase over the foreseeable future. On August 11, 2008 the CCAA finished January 2006 applications. Seven months later, the CCAA is just beginning the referral of families that have applied in early March 2006. Since August 2008, the wait time has increased six months.

While some families speculated that after the Olympics referrals would pick up, this has failed to happen. In fact, a look at the "supply-side" of the equation provides evidence that there will probably not be any significant speed-up in referrals until the last half of 2009, if at all. The China program continues to labor under an increasing demand trend, and a declining supply of children to fill that demand.

Looking a the top six Provinces, 2008 saw the continuation of a declining trend. In 2006, total submissions for Guangdong, Jiangxi, Hunan, Chongqing, Guangxi and Jiangsu were 7,427, a number that fell to 5,750 in 2007, and which fell further last year, to 4,958. Thus, since 2006, submissions for the six largest Provinces have declined 33%.

In the last year, trackers of referrals have noticed an uptick in the number of male children being referred. Most of the data is anecdotal -- agency announcements, Yahoo DTC groups, etc. Looking at the six largest Provinces lends substantiation of this conclusion. In 2006, 611 boys were submitted by our study Provinces. This number increased to 879 in 2007, and increased further in 2008 to 1098. In fact, the percentage of boys referred has increased from 8% in 2006 to 15% in 2007 to over 22% in 2008.

The increase is not consistent across China. The largest increase in male referrals was seen in Guangdong Province, which saw male referrals more than double from 2006-2008, increasing 129%. Whereas Guangdong's referrals were 8% male in 2006, in 2008 that percentage climbed to nearly 24%.

Jiangsu Province also saw a large increase, more than doubling between 2006 and 2008. Hunan Province saw their male referrals increase 80%, while Chongqing's male referrals increased 61%. Jiangxi Province increased 45%. while Guangxi increased the least, increasing only 22.5%. Clearly things are changing in China. As the real numbers of female referrals drops sharply, the real number of male referrals is increasing. This is turning preconceived notions of China on its head.

One probable explanation for the increased number of boys being submitted is the changing attitudes towards girls in general, and increased pre-marital sex among China's youth. A single woman is just as likely to abandon a boy child as a girl, so as sexual mores change among China's youth, one would expect the sex-ratios of abandoned children to equalize. I believe this largely explains the increased number of boys being found.

However, total submissions across China have continued to decline, mostly the result of fewer abandonments. This decline can be attributed to several factors -- ultra-sound technology, changing attitudes towards girls -- but the largest factor, I believe, is that the black market for children results in fewer children from being abandoned. The Chinese are nothing is not practical.

One can see the problem orphanages face by analyzing the "wholesale" prices (paid by traffickers for healthy infants) of trafficked children over the past five years. In 2001, for example, traffickers in one story received 200 yuan for each child. This number had risen to 1,200 - 2,000 yuan per child by 2003. By early 2009, reports indicate that the wholesale price has risen to 7,000 yuan for girls in some cases.

As the market for black-market children has increased, fewer Chinese families simply abandon their child on the street. Thus, orphanages have seen their numbers of foundlings decrease. This is true even in the orphanages involved in baby-buying programs such as Fuzhou (Jiangxi), which have seen their numbers decline even as "rewards" have been increased for children. Clearly the market has moved away from the orphanages.

It will be interesting to watch what impact the increased donation will have on submission rates. The increase from $3,000 to $5,000 was ostensibly made by the CCAA to help offset the declining revenues resulting from fewer adoptions. But as we move into 2009, it will be interesting to watch if any orphanages see significant increases in the number of children "found". Preliminary surveys of January and February 2009 submissions indicate that the number of children being "found" is increasing. In July we will look to see if these increases are concentrated in any specific areas or orphanages.

If there is an increase in submissions, will it be children that were "held back" (found before 2009)? Or will the increase come from new "foundlings" (children found after the increase)? Or will the increase raise the financial bar for domestic families, resulting in even fewer orphanage children being adopted domestically? Supporters of the international Hague agreement on adoption will want to watch these trends as they develop.

At this point, there is little reason to believe that referral rates will increase significantly in the near-term. As of the end of 2008, submission rates were overall in decline, but with the sex ratio of the children submitted increasing.

Of the 335 boys submitted by Guangdong Province orphanages in 2008, 150 of them were classified as healthy (NSN), or 45%. In 2008, 779 healthy females were submitted, which represented 72% of the female submissions. Thus, there is a higher percentage of healthy girls submitted, but not a dramatic difference.

Concerning holding back. All SN children have their paperwork held back as the issues involved are diagnosed, etc. One can see this by analyzing the time that transpires from the date of finding until the date of file submission. In Guangdong, for example, SN boys have their files submitted, on average, 593 days after finding, as compared to 714 days for girls. Healthy boys have their files turned in 462 days after finding, as compared to 314 for healthy girls. Much of this delay can be attributed to the orphanage "batching" that occurs in Guangdong, so most other Provinces would have shorter submission times. But one can see the overall pattern.

In general, healthy boys are "held back" more than healthy girls, but "SN" boys have their files submitted sooner than "SN" girls.

Looking at Hunan we see the same pattern. Healthy boys are submitted about 241 days after finding, while healthy girls are submitted 158 days after finding. SN boys, however, are submitted on average 220 days after finding, while SN girls are submitted 355 days after finding. Thus, the same pattern holds -- Healthy girls are submitted quicker than healthy boys, but SN boys are submitted quicker than SN girls.

It will be interesting to see what if any effect the economic slow down and the loss of millions of coastal facory jobs in China has on the abandonment rate. I sadly suspect that we will see an increase but pray that they are not quickly bundled up and sent to the IA program.

Also, I find it interesting your comments on the days after finding to submission for these children. It looks like well over year average - I read on RQ a lot of 8 month old placements. Perhaps the shorter the placement time, the less chance of funny business or are SWI's given a stipend based on "the time in house" verse placement.

I don't think general economic conditions will have a significant impact on the number of children made available, but time will tell. There are a lot of variability in the submission times. In Jiangxi, for example, many of the children are processed within weeks of entering the orphanage. Generally speaking, most directors begin the process very quickly. The earliest file sent in Hunan in 2008 was 10 days, for example, with the longest being 3,663 days.

Generally speaking, shorter process times are an indication of "funny business," not the other way around. There is little incentive for directors to keep a child "in-house" since the amount received for care is less than the cost to care for a child.

Sorry I fear I don't catch what you mean by "funny business" : it the submission time an indication of directors professionalism ?My daughter (aged 18 months when adopted) comes from an orphanage where they obviously wait until the baby is 12 month until submitting the file to the CCAA: what is the reason for waiting "so long" ?

I have not analyzed the submission times to determine if there is a correlation between how quick an orphanage submits children and the integrity of their program. If an orphanage submits their children quickly does that imply they have incentive programs? Don't know. If an orphanage waits a year does that mean they are ethically run? Don't know.

"Moving away" from the orphanages means that the value placed by China's black market is more than the orphanages are able to pay, given their own market constraints. Thus, while there are still some families that will simply abandon (although this number is small and declining), those families that investigate other options find that the local "baby broker" is able to pay more for their child than the orphanage. Orphanages partially offset this by telling birth families that their children will go internationally to rich Western families. This is attractive to many families, but only to a limited extent.

The increased donation has now re-aligned the price ceiling orphanages can offer. In one city in Jiangxi we were recently in, the price paid by the orphanage had increased to 6,000 yuan, the highest I have seen so far.

Looking at just January and February is a little risky to base conclusions on due to publication schedules, but so far (comparing submisisons in January-February 2008 with 2009) Guangdong is up 28% (202/259), Jiangxi is up 98% (136/270), and Chongqing is up 27% (63/80). Guangxi down 7% (103/96), while Hunan continues to see significant declines (94/32). Taken collectively, these five Provinces are up 23% so far in 2009.

"while there are still some families that will simply abandon (although this number is small and declining), those families that investigate other options find that the local "baby broker" is able to pay more for their child than the orphanage. Orphanages partially offset this by telling birth families that their children will go internationally to rich Western families"

First, how do orphanages 'tell' birth families? How do orphanages and birth families communicate?

Second, it seems to me from your statement above that there are two separate problems or issues that you tend to conflate in your writing. One is the kidnapping of children, whose families would want to keep them, and the second is the selling of children by birth families to intermediaries who then pass them onto the orphanages. In the second case, the families are wanting to 'offload' those children anyway. Given that in rural China, as in many non-Western countries, there isn't the same moral repugnance towards exchanging money and people, it is only logical that money will change hands. We know that historically girls have been sold by poor families to richer families etc for many generations. In other words, it is part and parcel of Chinese rural culture, if such thing exists. This does not mean that the children are being taken from their birth families by force, does it?

You are correct that there are two issues involved -- the kidnapping of children, and the "off-loading" of children. In my writings, I have been careful to differentiate the two.

The most common method of communication is through the birthing doctors in the area hospitals. The doctors are promised "finder fees" for each child that is "off-loaded", and they thus engage families in conversation during their pre- or post-natal care to determine of the family is wanting to keep their child. One can imagine a conversation that involves money having an impact on a family that is uncertain as to what they should do with their newborn.

However, by offering money in a "don't ask, don't tell" environment, one can also introduce the other problem -- that of kidnapping. This is what happened in Dianjiang, possibly in Hunan, and without a doubt in many other places. You can't offer rewards for children and prevent that from happening -- it goes hand-in-hand.

That is why the orphanages must stop "rewarding" finders who bring children to the orphanages. By doing so, they encourage everyone to enter into unethical or illegal practices.

I certainly do not wish to bury my head in the sand and I respect what you do and why you do it; but I am finding it increasing difficult to read your blog. I am starting to feel as if international adoption is evil and those who chose it as a means to start a family are perpetuating this evil practice.I have an internationally adopted child and she is the light of our life. Did we contribute to something unspeakable? Was our daughter "sold" for a profit so we could have a family?It is devastating to think about it. I thank you for your thought provoking work but I am struggling with the realities of it.Respectfully,Wen Bin's Mom

I have never implied that the IA program is evil, but there are corrupt components to it. All I seek is reform -- bring the program in line with international law. If that can't be done, end it. I am not saying that parents who adopted did a bad thing, or were perpetrating anything in and of themselves. I, like you, adopted because I believed there was a need. I don't feel guilty, I worked with the information I had at the time.

Families who have adopted (or seek to adopt) have an obligation to work to making the program fair for all involved -- the children, families inside China, and themselves.

Our family has decided not to adopt from the China SN program becuase of the information we have seen on this blog and in the media. I know of two other families who also decided against it for the same reasons. I think you are finally getting the message through that adoptions from China are corrupt. Besides if the IA program does stop then the people of China could adopt these children. The SN children can still get care through the Tomorrow Plan and I bet a lot of them would be adopted in Chian too. Attitudes are changing and adopting a child with a disability is not frowned upon so much anymore and the government will pay for their health expenses. We have decided to adopt our next child from Ethiopia or Haiti where the need is still great and it is not too corrupt now. I think there is not really a need in China for IA adoptions anymore. They have a good economy and can care for their own now.

OMG please tell me that the earlier post is a big joke!! Choosing Ethiopia or Haiti over a child from the China SN program? HAHAHA Anonymous! You sure have your wits when it comes to a great April fools post!Yep, I say choose Ethiopia! Then you can be sure your adoption is ethical. Ooh no no better yet pick Malawi then you may even get more attention!!

I'm wondering what you, Brian, think is the most common scenario with special needs babies. (I don't agree with the anonymous poster that believes China has changed enough that people are seeking to adopt cleft babies, or babies with any other visible special needs)

Do you think money is now being offered to mothers who give birth to a baby with an obvious special need? Or, are these the babies that are more likely to be actually "left to be found" in hopes that someone else can provide the medical attention they need?

Also, do you believe the young, unwed mothers who are trying to hide their pregnancy from family (migrant worker for example) is savvy enough to know about the black market dealers, or even the orphanages?

I have spoken to China natives who had no idea there were children who were abandoned and living in orphanages. How much about IA is common knowledge in China?

Thanks for all you do. Your research is thorough and your explanations are easy to understand. Once we "know", we cannot ever "not know". But innocence lost can lead to growth, and perhaps one day I'll have a better explanation for my children, who I love with all my heart, and for whom my heart breaks for all they have lost.

By far the most common way for families to learn about "financial opportunities" is from the medical professional they see pre-natally. Orphanages very frequently make arrangements with doctors to make families aware of "rewards" available. Aside from that, nearly every village has a "go-to" person that families know about. There are few secrets in this area.

I don't know what is happening with special needs children but I suspect there is little market for them. The main problem is that most families 1) are afraid to assume unknown medical risks; and 2) want a healthy, attractive child to represent the family. These two impulses prevent any substantial market for SN kids from developing.

China is a very large country, with a broad spectrum of people. There certainly are people who adopt special needs children. Most families keep their special needs children. But are there enough families willing to step forward to adopt the children that SOME families abandon? It is a good question, the answer of which I don't know.

I do know that the government could do more to encourage the adoption of SN children inside China, but does nothing.

Hi. We just met with an agency today that said the wait time is 36 months (estimated) plus the 6 month dossier time. It made us wonder whether there is a need for us to adopt. We fear that we are creating a marketplace that might not be necessary. It was explained that the long wait times were due to the flood of applications before the regulations changed and domestic adoption being a choice. Do you think the worldwide recession will shorten the waittimes as fewer applicants come in and more children are abandoned.

I think your wait will be longer than three years, that you will be adopting a child that should have been adopted inside China, and that will be creating a market. You are right that there isn't a need for an IA program for healthy infants.

I think you will be quite disappointed in your quest for a corrupt-free adoption. All you will need to do is dig a bit into the Ethiopia and Haiti programs to realize that there is just as much funny business going on there as with any other country program. Perhaps you could try for a private domestic adoption from here in the US? Maybe you'll encounter what my friends did, and a birth mother will demand yet another check for living expenses, cash the check and the very same day call you to inform you that she's selected a different couple. Maybe you will learn during your Ethiopian adoption that the only thing separating your new child from his/her birth family is money...you have it, they don't and so you receive the gift of the child and they suffer the pain of relinquishing their child into the arms of someone lucky enough to have been born elsewhere.

I believe that in many cases, adoption is in the best interest of the child. But I challenge you to present me with compelling evidence of ANY adoption program that is free of corruption and entirely ethical.

Brian, As someone who logged into the NSN program back in mid 2006, the information available to me has changed dramatically. Your earlier post has stayed with me and I am left wondering if you could expand by what you meant by "Special needs is another story, if you are open to that."

You wrote: "I think your wait will be longer than three years, that you will be adopting a child that should have been adopted inside China, and that will be creating a market. You are right that there isn't a need for an IA program for healthy infants.

Special needs is another story, if you are open to that."

Looking forward to your clarification on how the SN program is another story.

The SN program has, I believe, the opposite problems as the NSN -- many children and fewer families willing to adopt. Thus, I don't believe that adopting a SN child contributes to baby-buying programs (although I have had experiences that might prove that supposition incorrect) that most orphanages have for healthy children. Additionally, SN children generally aren't targeted by Family Planning, etc., that many healthy children are.

Simply stated, the SN program doesn't seem to have the issues that the NSN program does.

Thank you for the warm note about our impending adoption. You are my candid, research-based source. As such, your comment, "(although I have had experiences that might prove that supposition incorrect)" is nagging at me. I am left wondering if you could please explain?

While in Changde, Hunan, my sister-in-law was approached on the street, out of the blue, by the gate-keeper of the Changde orphanage. After some small talk, the gate-keeper asked her if she was from the area, and knew of anyone that had a child they didn't want to keep. To make a long story short, we recorded a subsequent conversation the next day in which the gate-keeper (working for the orphanage) offered 1,000 yuan for a cleft-lip baby which my sister-in-law indicated she knew about. This offer was made in connection with a 3,000 yuan offering for a newborn baby girl.

So, while I feel that the supply/demand equation favors the assumption of an ethical program in SN children, this experience gives me pause. Perhaps given the growing focus on SN children the orphanages are now also seeking out correctable SN children.